Complication rates after total ankle arthroplasty in one hundred consecutive prostheses

Abstract

Introduction Total ankle arthroplasty is increasingly used as an alternative to arthrodesis to treat advanced ankle arthritis. However, the outcomes and postoperative complications are poorly described. Patients and methods Between March 2005 and May 2010 114 S.T.A.R. prostheses were implanted by one surgeon at our institution. We retrospectively analysed the demographics, clinical outcomes and radiographic characteristics of 100 ankle prostheses (97 patients).Results The average follow up was 36 months. The average preoperative AOFAS score of 36.87 (22-58) significantly increased to 75.99 postoperative. A total of 87 % of the patients reported a better life quality. Twenty-seven ankles incurred complications after primary surgery, and 21 prostheses required revision surgery, including four patients who required arthrodesis. Conclusion Our study shows a high satisfaction rate after total ankle replacement and clear pain relief. Patients with a body mass Index higher than 30 showed a higher rate of complications. Compared with ankle fusion, the rates of complications are comparable.

Are our expectations bigger than the results we achieve? A comparative study analysing potential advantages of ankle arthroplasty over arthrodesis

“…Furthermore, premature deterioration of other foot joints with substantial arthritic changes was found in the foot as a long-term result [4]. On the other hand, significant improvements including subjective outcome, more normal ankle function, gait kinematics and gait kinetics were observed following total ankle replacement (TAR) [5,6]. In cadaveric studies it was suggested that modern prosthetic designs are even able to achieve close to normal kinematics [7].…”

The Current Trend of Total Ankle Replacement

“…In the United States, fixed-bearing, two-component designs are more commonly used. S. Noelle reported that STAR prostheses achieved a high satisfaction rate following TAR, and exhibited clear pain relief in patients between March 2005 and May 2010 [33]. J.R. Jastifer reported that the overall implant survival of STAR prosthesis was 94.4% at a minimum of 10 years of follow-up.…”

No free lunch in orthopedics

“…Until recently, ankle arthroplasty was fraught with high rates of loosening and revision [11]. Spine surgery has seen tremendous advances in techniques in implants as well as cost, but proven improvement in patient outcomes has not been well documented [12,13].…”